Inside Angelina Jolie's Breast Reconstruction Surgery

Photo Credits: PR Photos

On first glance, the last thing 37-year-old Angelina Jolie needs is cosmetic surgery. Thousands of women turn to surgery to replicate her beautiful features. Many were shocked when the actress announced her secret preventive double mastectomy in a first person account in the New York Times this week.

After learning that she carried a gene putting her at higher risk of developing breast cancer, the disease to which she lost her mother, Jolie made the decision to have both of her breasts removed.  “Preventative mastectomy is often recommended when it is determined that patient is a carrier of the ‘faulty’ BRCA gene, like Jolie. It is important to note that there are likely many other genes that can lead to a genetic pre-disposition to breast cancer, but these genes have yet to be identified,” explains Kirkland, WA, plastic surgeon Sarah McMillan, MD

For three months she underwent medical treatment related to the mastectomies, which included a “nipple delay” procedure to save the nipples as well as a major operation to remove breast tissue. Her final surgery involved breast reconstruction with implants. “Mastectomy patients may choose saline or silicone filled implants with smooth or textured surfaces in round or tear drop (anatomical) shapes. The choice is governed by their desires and their anatomy,” says Encino, CA, plastic surgeon George Sanders, MD. “Either implant would provide a very natural reconstruction and symmetry,” adds St. Petersburg, FL, plastic surgeon Jeremy A. Benedetti, MD.

And while we know it was not Jolie’s intention to enhance the look of her breasts, it’s likely that she was able to improve upon their appearance. “It has been my experience that in women like Jolie, their breasts can look better. But that is never the reason to do this procedure; the reason to do the procedure is to minimize the risks of breast cancer,” says Dr. Benedetti, who advises to always choose a board-certified plastic surgeon. “I have not examined her but if she did lose volume and develop some breast droop from having children and/or breast feeding, this could be improved with this type of surgery,” Dr. Benedetti explains.

We predict Jolie will still require some medical attention down the road. As with most surgeries, follow-up treatment is usually recommended. “This may involve yearly visits with her doctor and periodic MRIs or ultrasounds to check on the implants (every 3 to 10 years). Other follow-up visits for medical reasons related to her slight chance of developing breast cancer will probably be more frequent,” says Dr. Sanders.

According to Jolie, her chances of developing breast cancer have dropped from 87 to less than 5 percent. “The decision to have a mastectomy was not easy. But it is one I am very happy that I made,” she says.

The actress claims to have shared her story to promote awareness of the disease and the treatment options available. “This courageous act by Jolie will do much to educate women about the options available to women who have breast cancer or are at high risk for developing the disease. Much of the fear of deformity that results from surgery will hopefully be laid to rest,” says Dr. Sanders.

What do you think of Jolie’s decision?

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14 Comments
  • ps
    Posted on

    I had breast cancer but caught it early, DCIS stage 1B. Ten years later, I found out I had the BRCA gene. Recently had a negative biopsy but now am considering a double mastectomy that I only though I would do if I got cancer again. It may be easier to do this procedure without chemo and radiation...but I've seen pictures and I get nauseated. Because of the BRCA gene, this procedure is not considered elective. This is an extremely difficult decision. It is like self mutilation.

  • Karen Eakins
    Posted on

    Positively groundbreaking in cancer treatment, choices, information and Courage. Bravo

  • justchecking
    Posted on

    I wish that she had kept her decision private because each woman's case is very different. She tells women that 'they have an option'. As it turns out from an M.D. at Dartmouth 99% of women DO NOT have this BRAC mutated gene so she may be misleading or causing others to over react. She also has the money to get the very BEST. I think she'd had transplants for sometime. What does she recommend for women who do not have her kind of money? I think Jolie is more clever than brave. I feel sorry for any woman though who must go through a breast cancer ordeal. God Bless Them! Jolie had the best chance at reconstruction with no disease in her breasts and all the money in the world. Still, for her sake, I wish she'd not had this mutated gene and feel sorry for her and her family.

  • Sunny
    Posted on

    If that's what she wanted, good for her. I wish she would have kept it private.

  • pearl
    Posted on

    I think it's good that Angelina had it done if you have the gene. My niece at 38 had breast cancer and had a double mastectomy last year, but since she was unemployed and had no medical insurance was not able to get breasts reconstructed, I checked with all the cancer web sites to see if she could get some help, but so far no luck. Her mother has breast cancer which now has spread to her liver and lungs.I think wemon shoud know but we need to find help for women that do not have insurance too,

  • Lisa
    Posted on

    If you have been touched by cancer, you would well understand why a woman would choose a bilateral mastectomy. Jolie has been gravely touched by cancer with the loss of her mother. The words "you have invasive breast cancer" have a certain sting to them especially when you are a mother. Anything you read about cancer survival is ominous at best. Doctors are afraid of malpractice suits so they don 't paint hopeful pictures at all for their patients....which I think results in an inaccurate, impersonal assessment of your personal prognosis... These are very challenging shoes to wear indeed. removing my breasts was the absolute least of my concerns....and still is almost three years later. My existence today has nothing to do with what my breasts look like.....it's about overcoming the emotional scars that the medical establishment and the general public impose upon you as you exist as a cancer patient. Our country is ALL about treatment...because treatment is huge business in the U.S.....what about prevention?...via fewer toxins in our food, water, air, etc?...where is our FDA? Did you know that in Germany women are first given a mammogram and then immediately after an ultrasound of their underarms and the tissue above each breast? This is done as a routine, annual breast exam. When I asked why (I now live in Germany), the doctor told me that mammograms do not detect inflammed lymph nodes or tumors in these areas. And, yes, doctors actually perform the ultrasounds and read the results right then and there to you...the human being on the table. Are US medical insurance companies just trying to save money...why isn't the American Cancer Society recommending ultrasounds in addition to mammograms like Germany is doing?....politics perhaps?...payoffs.... I think Ms. Jolie made a very personal decision ...one we all really have no right to comment on....but one I truly understand.

  • Tabby
    Posted on

    Honestly I think this is a drastic procedure because everybody has some form of cancer cells in their body, . Removing body parts hoping you do not come down with cancer is crazy. Why not live a healthy life style and have checkups. The medical field is now going to have a hay day. If a guy was in fear of testicle cancer do you think he is going to remove his testicle in fear? What about fear of brain cancer, bone cancer and so on. I think is insane.

  • Michoel
    Posted on

    I'm certain that Jolie believes she made the right decision; however, cancer micro-tumors exist in everyone. The implication that there is only ONE way to reduce breast cancer risk is a complete untrue. There are thousands of options and strategies for preventing cancer. Never be cornered into surgery by a group of surgeons pushing irrational fear. The claim that cutting off healthy breasts somehow "empowers" women is wrong. Women are far more empowered by honest information on nutrition and healthy living that allows them to keep their bodies intact rather than being sliced up by dishonest cancer surgeons. Big pharma is making huge profits off of cancer treatment........................

  • Bette
    Posted on

    I applaud Jolie for taking her health and life into her own hands. As for the BRCA gene, although not exclusively, but primarily, it's a Jewish gene. Many women who are not Jewish, especially from Ashkenazie Jewish backgrounds (European) don't know they have it because they don't know they have any Jewish ancestry. Jews during the Spanish Inquisition, crusades and other historical persecutions, often hid their Jewish family history to avoid torture and murder. Thus, those Jewish identities were lost thru the decades. There are many instances of Mexican/Mexican American Indians who have been found with the BRCA gene to find out they were one of the fleeing Spanish Inquisition families. THE TEST IS NOT EXPENSIVE. ORGANIZATIONS SUCH AS THE VINCE LOMBARDI CANCER CLINIC WILL DO THIS SIMPLE BLOOD TEST FOR A NOMINAL FEE. BUT, JUST BECAUSE YOU DON'T HAVE THE GENE, DOESN'T MEAN YOU WON'T GET BREAST CANCER AND IF YOU DO HAVE IT, IT DOESN'T MEAN YOU WILL GET BREAST CANCER. IT MEANS BE VIGILANT

  • Shazz
    Posted on

    Ms. Jolie is fortunate she could afford the test and the best in surgeons, having implants probably added to her risk. Hopefully she will be all right, but as anyone who has experience cancer you just never know.

  • Andrea
    Posted on

    I think it's wonderful that she announced her BRCA status and surgery, and thank you for covering it and raising awareness even more. I just want to point out that a prophylactic double mastectomy is far from "cosmetic" surgery, as you refer to it, it's reconstructive surgery. I had this myself for the same reason as Jolie -- it's nothing like having breast enhancement or other cosmetic procedures, it's a major surgery with anesthesia, hospital stay and lots of pain and discomfort.

  • Tina
    Posted on

    I think it was a good decision on her part, but as far as calming fears about deformity...I had breast cancer 5 years ago in july and I ended up with numerous surgeries. The first surgeon I had made a mess of things and the second surgeon did the best he could to fix what she messed up. Breast cancer isn't just about the fear about just how the breast will look,but more so that you survive it. I wish I would have had the money to travel anywhere in the United States to have fixed my breast, but when you have to rely more on insurance it does not end up that way for most.

  • Lisa
    Posted on

    Smart.

  • Marilyn
    Posted on

    Angelina Jolie is a brave and courageous woman. She put her health ahead of her ego. It would be great if more of Hollywood's stars were more like Ms. Jolie. Good health to you and yours Angelina. You have a beautiful family and obviously you were thinking of them in your decision. May God Bless you and your Family

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